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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

99000403

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Audrey BenedictTobin Sex Female

Date of Birth January 14, 1921 Place of Birth HalifaxCounty of Halifax

Name of Father John Martin Tobin MAIDEN NAME of Mother Mary Ellen Sullivan

Were the Parents married at the time of the Birth? Yes

Residence of Father when child was born 47 Bauer St. Halifax Present address of Father deceased

Occupation of Father at Birth of child Grocer Place of birth of Father Nova Scotia

Race Caucasian Name and present address of Physician in attendance at birth

Signature of Applicant Audrey Benedict Zimmerman Address of Applicant 65 Kennebec Cres. Rexdale, Ontario Date

Relationship of Applicant to child same person

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Audrey BenedictTobin

Born at Halifax in the County of Halifax

That Audrey BenedictTobin Whose Birth is sought to be registered was

born at Halifax Halifax County on January 14, 1921

My knowledge of the fact and date of such Birth is based on the following Circumstances:

My Baptismal Certificate now on file at the office of the Registrar General of Nova Scotia, as Class A evidence awaiting this affidavit

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